Publication: Evaluation of mucosal status in the follow-up of pediatric patients with celiac disease: the role of serology
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Date
2022-09-01
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Abstract
Recent guidelines suggest non-biopsy serology-based approach for the diagnosis of celiac disease; however, there is no evidence-based data regarding noninvasive follow-up of mucosal healing. The aim of this study is to investigate the efficacy of serology in reflecting mucosal status in the follow-up of pediatric patients with celiac disease. This is a validation study conducted at a university hospital. Patients who had biopsy proven celiac disease (Marsh III) at diagnosis, and had been followed-up for at least 12 months, were prospectively evaluated with duodenal biopsies. tTG-IgA and EMA tests were performed on the day of endoscopy. One hundred four patients with a mean age of 7.4 +/- 4.02 years were included in the study. The sensitivity and specificity of tTG-IgA were 85.2% and 61% respectively, with a high negative predictive value (NPV) of 92.2% but a very low positive predictive value (PPV) of 43.4%. We found that a cutoff value of 68.5 U/mL for tTG-IgA had a sensitivity, specificity of 85.2% and 85.7% respectively. The AUC was 0.891. The sensitivity and specificity of EMA was 77.8% and 87% respectively, with a high NPV of 91.8% but low PPV of 67.7%.
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Tıp, Dahili Tıp Bilimleri, Çocuk Sağlığı ve Hastalıkları, Sağlık Bilimleri, Medicine, Internal Medicine Sciences, Child Health and Diseases, Health Sciences, PEDİATRİ, Klinik Tıp, Klinik Tıp (MED), PEDIATRICS, CLINICAL MEDICINE, Clinical Medicine (MED), Pediatri, Pediatri, Perinatoloji ve Çocuk Sağlığı, Pediatrics, Pediatrics, Perinatology and Child Health, Celiac disease, Endomysium IgA, Pediatric, Serology, Tissue transglutaminase IgA, PERSISTENT VILLOUS ATROPHY, GLUTEN-FREE DIET, RECOVERY, TRANSGLUTAMINASE, PREVALENCE, GUIDELINES, ANTIBODIES, DIAGNOSIS, CHILDREN, SOCIETY
Citation
Sengul O. K., Akkelle B. S., Ay P., Volkan B., Tutar E., Celikel Ç., Ertem D., "Evaluation of mucosal status in the follow-up of pediatric patients with celiac disease: the role of serology", EUROPEAN JOURNAL OF PEDIATRICS, cilt.181, sa.9, ss.3283-3289, 2022